Rapid Calculation of Standardized Placental Volume at 11 to 13 Weeks and the Prediction of Small for Gestational Age Babies
Abstract
Fetal growth restriction is one of the greatest risk factors for stillbirth. This pilot cohort study examined whether rapid placental volume (PlaV) calculation at 11 to 13 + 6 weeks can predict the small for gestational age (cSGA) baby. Women with singleton pregnancies were recruited (N = 145), a static three-dimensional (3-D) volume was captured, and the placental volume was computed using a semi-automated technique. Regression analysis explored the relationships between customized birth weight, placental quotient (PQ), standardized placental volume (sPlaV), and other predictors of SGA (including pregnancy-associated protein and uterine artery pulsatility index (PI). The results were examined using receiver-operating characteristic (ROC) curve analysis in the total population and then in the 2 subgroups whose members were classified as low risk or high risk at booking. Both PQ and sPlaV were significantly different for cSGA pregnancies compared to appropriate for gestational age (AGA) babies (p = 0.003 and <0.001, respectively) but only sPlaV was normally distributed. The independent predictors of birth weight (sPlaV, pregnancy associated protein, and nuchal translucency) were combined to produce a predictive model for cSGA. The ROC curves for prediction of cSGA in all 143 women gave areas under the curve of 0.77 (0.66 to 0.87) for sPlaV alone and 0.80 (0.69 to 0.92) for the combined model. When this was applied to the low-risk group, the areas under the curve were 0.82 (0.69 to 0.94) and 0.84 (0.72 to 0.95), respectively. For the high-risk group, the areas under the curve were 0.67 (0.45 to 0.86) for sPlaV alone and 0.76 (0.55 to 0.96) for the combined model. The use of this rapid-image analysis technique and dimensionless index to correct for gestation brings the possibility of an early combined screening test for the cSGA baby a step closer.
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A small placenta at the first-trimester scan is associated with an increased risk of impaired fetal growth and preeclampsia.
“A small placenta at the first-trimester scan is associated with an increased risk of impaired fetal growth and preeclampsia6,7.”
From Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization (2023) · cites this paper as [7]
PlVol has been demonstrated to be independent of other biomarkers for SGA, such as PAPP-A and nuchal translucency.
“As PlVol has also been demonstrated to be independent of other biomarkers for SGA, such as pregnancy-associated plasma protein A (PAPP-A) (8, 11) and nuchal translucency (11), a recent systematic review concluded that it could be successfully integrated into a future multivariable screening method for SGA (12) analogous to the 'combined test' currently used to screen for fetal aneuploidy.”
From Fully automated, real-time 3D ultrasound segmentation to estimate first trimester placental volume using deep learning (2018) · cites this paper as [11]
Many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age and preeclampsia.
“Since then many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age (SGA) (11) and preeclampsia (7).”
From Fully automated, real-time 3D ultrasound segmentation to estimate first trimester placental volume using deep learning (2018) · cites this paper as [11]
There have been semi-automated and fully automated methods proposed for placental segmentation from 3D ultrasound, with varying results.
“There have been some semi-automated and fully automated methods proposed for the segmentation task, with varying results [10,11,12,13,14,15,16,17].”
From Fully Automated Placental Volume Quantification From<scp>3D</scp>Ultrasound for Prediction of Small‐for‐Gestational‐Age Infants (2022) · cites this paper as [10]
Current techniques for quantifying placental volume and morphology from 3DUS images require substantial manual input, which can be cumbersome and poorly standardized.
“As a result of these challenges, current techniques for quantifying placental volume and morphology from 3DUS images require substantial amount of manual input from the user, which can be cumbersome and poorly standardized.”
From Minimally interactive placenta segmentation from three-dimensional ultrasound images (2020) · cites this paper as [8]
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“Since then many studies have demonstrated that a low PlVol between 11 and 13 weeks of gestation can predict adverse pregnancy outcomes, including small for gestational age (SGA) (11) and preeclampsia (7).”
BackgroundMethodSelf-citationUse of artificial intelligence and deep learning in fetal ultrasound imaging
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Self-citationVolume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta
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Self-citationCombining Deep Learning and Multi-atlas Label Fusion for Automated Placenta Segmentation from 3DUS
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Comparison of 2-D and 3-D estimates of placental volume in early pregnancy
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Self-citationSchwartz, N., Oguz, I., Wang, J., Pouch, A., Yushkevich, N., Parameshwaran, S., Gee, J., Yushkevich, P., & Oguz, B. (2022) · Journal of Ultrasound in Medicine · doi:10.1002/jum.15835 · Cited by 11 · see citing works
- Authors
- Collins, S. L., Stevenson, G. N., Noble, J. A., & Impey, L.
- Affiliations
- John Radcliffe Hospital (GB)
- University of Oxford (GB)
- Corresponding author
- Collins, Sally L.
- Venue
- Ultrasound in Medicine & Biology
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 39
- Issue
- 2
- Pages
- 253-260
- ISSN
- 0301-5629 (ISSN-L)
- OpenAlex
- W1974873383
- Cited by
- 39
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 3 · 2013: 3
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Medicine & Biology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- placental volume, small for gestational age, fetal growth restriction, early pregnancy, pregnancy-associated proteins, uterine artery pulsatility index, nuchal translucency, birth weight prediction, prenatal screening, 3D ultrasound
- MeSH terms
- Adolescent, Adult, Algorithms, Female, Fetal Growth Retardation, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Infant, Newborn, Infant, Small for Gestational Age, Male, Organ Size, Placenta, Pregnancy, Sensitivity and Specificity, Reproducibility of Results, Ultrasonography, Prenatal, Imaging, Three-Dimensional, Young Adult
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